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Pain after delivery, superficial gap in suture, open perineum. Scared

hello, i delivered 18 days back normally to a baby my first child , i had epistomy done i am not sure what the degree of cut is but it is close to my anus . On third day she told me the stiches have open. I have severe pain after 6 days of delivery and when i showed it to gyn on 15 th day she told me there is infection and mentioned in comment superficial gapping in suture. She gave mre drugs for infection and antiinflammatory . I just happened to check my perinium and it was very scary since it is wide open I am scared now will this be wide open alwzs or will iit close automatically Do i need to restich or it will heal on its own How many days will it take to heal automatically When this pain will go off on its own pls help
Asked On : Mon, 1 Oct 2012
Answers:  2 Views:  84
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OBGYN 's  Response
Hello, and I hope I can help you today.

First of all, I want to reassure you that your episiotomy site will heal, but it is just going to take some time.

Getting an infection of your episiotomy site or an obstetric laceration is uncommon, but it can occur just like any other type of surgical wound. When a wound is infected, it actually decreases it's chance of healing on its own if it is sewn closed again because the pus and infected tissue can get trapped under the skin. Letting a wound heal open is called having it heal by secondary intention, and it is the recommended way to treat infected surgical incisions and wounds anywhere on the body.

Normally, once the infection resolves, the gap between the sides in your vaginal opening will gradually get smaller and fill in with healthy tissue. However, this can even take 6-8 weeks to happen, and I understand that it may look scary right now before healing has taken place.

Taking your antibiotics and anti-inflammatory pain relievers is the correct treatment, and your pain should significantly improve once the infection is gone, but there are some things you can do to ease the pain and promote healing. For one, when you urinate, use a squirt bottle filled with warm water to wash your perineum (your doctor should be able to provide you with one) so the urine doesn't sting the incision. When you move your bowels, wipe carefully from front to back using moist baby wipes rather than dry tissue. Taking a sitz bath at least daily (twice is better) by dissolving a small amount of baking soda or epsom salts in a shallow tub of warm water and sitting in it for 20 minutes at a time will help soothe the pain as well as keeping the area clean. And trying to keep your legs together and avoid spreading out your labia will help the two sides heal back together more efficiently.

So in summary, your infected episiotomy should heal on it's own but it can even take 2 months to do so. Until then, I recommend you take your antibiotics and pain relievers, avoid any sexual activity or putting anything inside the vagina, and follow up with your doctor regularly to assess the progress of your healing.

I hope I was able to adequately answer your question today and that you feel better soon,

Dr. Brown
Answered: Thu, 20 Oct 2016
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General & Family Physician Dr. Imaad Mohammed Ismail's  Response
Welcome to healthcaremagic,
Normally episiotomy wound will heal within one month. In some women the wound may reopen and this is what has happened in your case. Infection is a common reason for stitches to open. In your case the stitches may have been reopened because of infection.
The best option in your case is to treat the infection first and allow to heal by itself (called as healing by secondary intention). This will take time, may be 2 to 3 months.
If your wound is clean after a couple of weeks your gynecologist may also consider resuturing of the wound.
Maintain proper hygiene so as to prevent infection in future. You can use a sitz bath. Purchase a sitz bathtub, fill it with some warm water and sit in it for a few minutes, twice a day. It works by keeping the affected area clean and increasing the flow of blood to it. Your pain will also gradually subside.
Hope that answers your question.
Regards, Dr.Imaad.
(if the answer has helped you, kindly indicate this)
Answered: Fri, 21 Nov 2014
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